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Related Experiment Videos

Stability analysis of craniovertebral junction fixation techniques.

Christian M Puttlitz1, Robert P Melcher, Frank S Kleinstueck

  • 1Department of Orthopaedic Surgery, University of California at San Francisco, 1001 Potrero Avenue, Room 3A36, San Francisco, CA 94110, USA. puttlit@itsa.ucsf.edu

The Journal of Bone and Joint Surgery. American Volume
|March 5, 2004
PubMed
Summary

A new posterior rod system for craniovertebral fixation offers similar stability to traditional plates and screws. Both methods effectively reduce motion after destabilization, suggesting clinical factors should guide surgical choice.

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Area of Science:

  • Orthopedic Surgery
  • Biomechanical Engineering
  • Spinal Fusion Techniques

Background:

  • Craniovertebral arthrodesis is challenging due to high upper cervical spine mobility.
  • A novel posterior rod system using C1 lateral mass and C2 pedicle screws has been introduced.
  • The stability of this novel construct when fused to the occiput requires evaluation.

Purpose of the Study:

  • To determine the primary stability of a novel posterior rod system for craniovertebral fixation.
  • To compare its stability against the standard method of longitudinal plates with C1-C2 transarticular screws.

Main Methods:

  • Ten human cadaveric cervical spines (C0-C4) were tested under pure moment loads.
  • Four conditions were evaluated: intact, destabilized (odontoidectomy), plate fixation, and rod system fixation.

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  • Stereophotogrammetry measured C0-C2 rotations to assess stability.

    • Main Results:

    • Destabilization significantly increased C0-C2 motion (flexion-extension, lateral bending).
    • Both fixation methods reduced motion by over 90% in the destabilized spine.
    • No significant biomechanical differences were found between the plate and rod constructs.

    Conclusions:

    • Both posterior rod systems and plate/screw constructs provide equivalent immediate stability for craniovertebral arthrodesis.
    • The choice between these constructs should be based on clinical considerations, not biomechanical differences.